| NPI | 1679797146 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM B POTOS President 414-281-9651 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: WI 14134) |
| Enumeration Date | 2007-04-13 |
| Last Update Date | 2008-11-21 |